How to treat chlamydia in men and women. Chlamydia in men: symptoms, regimen and course of drug treatment, possible consequences Drugs for the treatment of chlamydia
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Nowadays, treatment of chlamydia poses serious difficulties for patients and doctors, since often after therapy with antimicrobial drugs, this insidious disease re-manifests after some time. The problem is that many patients are diagnosed with chronic urogenital chlamydia, and many drugs are often ineffective.
To date, the problem of treating chlamydia has not been fully resolved and most experts argue that this can be explained by the formation of an inadequate or pathological response of the body to the infection. Specialists in this field conducted a set of studies that showed that in 70 percent of cases there was a cure for chronic chlamydia without resorting to the use of antibiotics, that is, spontaneous treatment of the infection by the body itself occurred.
But it is worth remembering that immunostimulants and immunomodulators cannot be prescribed without an immunological examination. This is primarily due to the fact that in 66 percent of patients with chlamydial infection, lymphocytes are not sensitive to immunomodulators.
Chlamydia: symptoms in women
Before we consider the symptoms of chlamydia in women, we note that in seven out of ten cases its absence is noted. First of all, chlamydia manifests itself in women as vaginal discharge, which can be purulent or mucous. The difference from simple discharge is the accompanying unpleasant odor and tint - it happens that such discharge has a yellowish color. Instead of discharge, pain may appear, which is noted from the external and internal genital organs. In addition, itching and burning appear (such sensations may accompany urination). A woman has a desire to scratch her skin, pain appears in the lower abdomen, which is concentrated in the pelvic area. Particularly severe pain is observed on the eve of menstruation, often bleeding that is completely unrelated to menstruation (they are usually called intermenstrual bleeding).
As for additional symptoms, there is weakness and a slight increase in temperature - characteristic symptoms of intoxication. In addition, there are simply no specific symptoms or signs that would indicate the presence of chlamydia (and neither for the woman nor for her attending physician).
Therefore, as you already know, the subjective feeling that a woman experiences regarding the genital organs and the state of their certain dysfunction, together with the identified symptoms that may also be present - all this is a reason for a subsequent visit to a gynecologist.
At the same time, inflammatory processes, for example, cystitis, endocervicitis and others, can be diagnosed at the appointment. It is possible that the woman will be diagnosed with bacterial vaginosis. As you may have guessed, each of these diseases may have its own symptoms, without any “link” to chlamydia, but it is possible to accurately check the presence of a connection only after tests.
Chlamydia in men: symptoms
It is worth noting that the symptoms of chlamydia in men, just like women, are absent or mildly expressed. The manifestation of symptoms, if observed, occurs at the beginning of the disease, and in most cases this manifests itself in the form of one or another inflammation of the urethra, which has a chronic form, the duration of which is about 2 months. But be that as it may, there are no special symptoms that would indicate that the cause of a certain ailment is the effect of chlamydia on the body of men.
Among all the symptoms that you need to pay attention to, it is worth highlighting the appearance of glassy discharge from the urethra (the so-called “morning drop”). The entire process of urination is accompanied by itching and burning. Pain is possible, but it is usually not pronounced and is concentrated in the urethra, scrotum, lower back and ovaries. An increase in temperature (usually within 37 degrees) and general weakness are often noted, as is the case when considering female symptoms indicating intoxication. In rare cases, cloudiness of the urine is observed, as well as the appearance of purulent threads in it. Patients may also experience bloody discharge after urination or during ejaculation. Regardless of the nature of the manifestations and the degree of discomfort, you need to go to the doctor as soon as possible. Chlamydia that spreads throughout the body can cause serious illness (such as infertility and impotence).
Chlamydia in pregnant women: symptoms and features
As already mentioned, chlamydia is a fairly common disease. Therefore, pregnant women’s interest in it is, of course, completely justified. So, what are the symptoms of chlamydia in pregnant women?
In accordance with the asymptomatic nature of the disease and the general prevalence, chlamydia during pregnancy is diagnosed very often. Typically, urogenital chlamydia is considered traditional and is characterized by the absence of symptoms. Almost its only manifestation is a disease such as cervicitis or pseudo-erosion of the cervix (in which the cervix itself becomes inflamed).
If a woman is infected with chlamydia while pregnant, and with a subsequent exacerbation of the process against a background of weakened immunity, the symptoms will be exactly the same as in non-pregnant women. Most often this is a mucopurulent form of cervicitis, endometritis with inflammation of the uterine mucosa, or choriomnionitis (the placenta is subject to inflammation).
The process of pregnancy with chlamydia is always caused by the occurrence of many obstetric complications, which pose a threat of miscarriage, ectopic pregnancy or spontaneous abortion (especially important for the initial period), as well as late toxicosis and polyhydramnios.
The infection may also be accompanied by complications such as abnormal placentation, untimely rupture of membranes, or premature placental abruption. In addition, intrauterine hypoxia, fever and weakness during childbirth cannot be ruled out.
It is worth noting that about 60% of cases indicate that mothers transmit the infection to the child with the further development of chlamydia.
In most cases, chlamydia manifests itself as ophthalmochlamydia (conjunctivitis). At birth from a mother with chlamydia, it is diagnosed in 30-50% of cases, by 3-15 days.
Chlamydia: symptoms in children
In newborns, chlamydial infection manifests itself in the form of diseases such as pneumonia, vulvovaginitis, proctitis, bronchitis, tubo-otitis, conjunctivitis. About 70% of cases the infection is generalized, which contributes to infection of various organs. But according to statistics, conjunctivitis is most often diagnosed.
One of its features is the gluing of the eyelids after sleep. The duration of chlamydial conjunctivitis is about 4 weeks (after it there is no deterioration in vision). Many children experience respiratory chlamydia (damage to the respiratory tract), the symptoms of which are the result of the infection affecting the lung tissue, which is explained by the aspiration of amniotic fluid with infection during childbirth.
In children with chlamydial pneumonia, the Apgar score is often less than six points. The early neonatal period in almost every infected person is always accompanied by the manifestation of a respiratory distress syndrome of a certain severity, and about 30% of cases cannot do without artificial ventilation.
Many people have hepatosplenomegaly from birth or on the first day after birth; in approximately 50% of cases, edema syndrome is diagnosed. Compared to the course of the disease in older children, during this period chlamydia infection is accompanied by severe toxicosis. At the same time, its maximum manifestation is diagnosed on days 5-7 of life, which is accompanied by pale skin and the formation of marbled patterns on it, as well as regurgitation, bloating and disorders of the nervous system. In half of the cases, an early form of lymphadenopathy is diagnosed, and in more rare cases, a rash (short-term or pinpoint) is diagnosed. By the 2-3rd week of the disease, a paroxysmal cough develops against the background of sputum discharge.
Possible complications of chlamydia:
Morning stricture.
It is a narrowing of the urethra as a result of cicatricial changes in the urethral mucosa. Treatment is carried out only through surgery.
Reiter's disease.
It is characterized by a triad of symptoms: conjunctivitis, urethritis and arthritis. Circinal balanoposthitis and skin lesions may also occur with the syndrome.
Orchiepididymitis.
Causing the death of Leydig cells and narrowing of the sperm ducts, which leads to the cessation of spermogenesis and male infertility.
PID (pelvic inflammatory disease) in women.
Chlamydial infection can penetrate the uterus, fallopian tubes, and uterine appendages, causing an inflammatory process there - salpingoophoritis, endometritis, salpingitis. A distinctive feature is the formation of adhesions and scars in the fallopian tubes, which causes tubal infertility and ectopic pregnancy.
Chronic prostatitis.
A disease leading to narrowing of the prostate ducts, death of the glandular tissue of the prostate gland, changes in the quality and quantity of prostate secretion, which in turn leads to rapid death and dehydration of sperm.
Often the presence of chlamydia causes premature termination of pregnancy; the danger is infection of the fetus during childbirth (according to statistics - 40% of all cases).
Diagnosis of chlamydia
Laboratory techniques used to detect chlamydia:
mini test. Each of you can purchase it at a pharmacy and conduct the analysis yourself. It's cheap, fast, but the accuracy of such tests does not exceed 20%. For this reason, you should not rely on its indicators;
general smear (microscopic analysis). For women, a smear is taken from the cervix, vagina and external opening of the urethra, for men - from the urethra;
linked immunosorbent assay. Determination of antibodies (IgM, IgA, IgG) to chlamydia in the blood. Such antibodies are produced by the body itself as protection against infection. Antibodies to chlamydia are detected during interaction with special preparations that contain chlamydial antigens, which together with antibodies create a strong complex that can be detected in various ways. In addition to simple scrapings, blood is also taken to perform the analysis using this method;
immunofluorescence reaction. The material taken from the urethra is stained with a special substance and examined under a special microscope (fluorescent). If chlamydia is present, they glow in the microscope lens like fireflies;
culture for chlamydia with antibiotic sensitivity analysis. This is the most time-consuming and expensive method, test results can be obtained in a few days. If the result is positive, then you definitely have chlamydia. Tests also show which antibiotic kills your infection;
polymerase chain reaction. To date, this method has the highest reliability - up to 100%. To perform the analysis, a small amount of material is required, and the results will be ready in 1-2 days. Although this method in rare cases can give false positive results.
Drugs for the treatment of chlamydia
For a full course of treatment of chlamydia with an active inflammatory process, a complex of medications will be required. The drugs used in treatment are selected by a specialist taking into account the clinical symptoms of the disease, the characteristics of the patient’s body, the severity of inflammation and the results of all tests - liver tests, immunograms, urine culture, complete blood count, results of ELISA, PCR and other laboratory tests.
Stimulation of the immune system - treatment of chlamydia, which is chronic, must necessarily include immune agents, since they are the most important component in the treatment of all sexually transmitted diseases.
If there is no good immune response of the body to the introduction of microbes into the body, then no antibiotic will cure the patient. The course of treatment for chlamydia should include adequate immunostimulation in a timely manner.
The choice of interferon drugs, immunomodulators, probiotics, hepateroprotectors, antioxidants, enzymes and treatment of chlamydia is presented in the tables.
All information about treatment regimens and medications is intended for informational purposes only. The complex of treatment for chlamydia should be prescribed exclusively by an experienced doctor based on test results, taking into account the patient’s medical history, as well as concomitant diseases and others.
Name of the drug |
Chlamydia treatment process |
Interferon preparations |
|
"Amiksin" |
250 mg once a day for two days, only during a relapse, after which 125 mg every other day for a whole month. |
"Cycloferon" |
10 days intramuscularly 200 mg, every day. |
"Neovir" |
250 mg intramuscularly No. 3 (only during relapse, every day), then every other day No. 3 |
"Ridostin" |
8 mg intramuscularly No. 3 (only during relapse), after 2 days |
"Poludan" |
200 mcg every day, intramuscularly No. 10 |
"Reaferon" |
14 days intramuscularly, every day 1 ml. |
"Interlock" |
500 IU intramuscularly for 14 days (every day). |
"Leukinferon |
for 21 days, intramuscularly 2-3 times a week |
Immunomodulators |
|
"Derinat" |
5 ml intramuscularly once every three days No. 5-10 |
"Timalin" |
every day intramuscularly No. 10 |
"Polyoxidonium" |
6 mg intramuscularly No. 10, every other day |
Enzyme therapy is one of the effective ways to treat chlamydia, through specially formulated mixtures of plant enzymes and highly active animals that have a positive effect on the body’s immune responses and reparative processes. The use of enzymes makes it possible to achieve maximum concentrations of antibiotics at sites of infection. Enzyme medications help stimulate the liver and kidneys, reducing intoxication of the body, and promote rapid recovery of the body.
Synergists and antioxidants, vitamin complexes are also a component in the treatment of chlamydia, since their use helps to increase the immune response against infectious agents.
Hepatoprotectors are drugs that increase the liver’s resistance to the pathogenic effects of various factors, improve the neutralizing function of the liver, and reduce the toxic effects of antibiotics. Many of the hepatoprotectors used also have immunomodulatory, antioxidant and anti-inflammatory properties, which, when treating a disease with antibiotics characterized by toxic effects, turns out to be necessary for a speedy recovery and protection of the liver.
Probiotics – prevention of intestinal dysbiosis and antibiotic-associated diarrhea; after treatment of chlamydia, you need to take probiotic preparations.
Probiotics |
|
Drug name |
Treatment regimen |
"Bifikol" |
|
"Bifidobacterin" |
5 doses three times a day 30 minutes before meals for 14-21 days. |
"Lactobacterin" |
5 doses three times a day 30 minutes before meals for 14-21 days. |
"Enteron" |
1 capsule twice a day 30 minutes before meals. |
What antibiotics are taken for chlamydia?
Antimicrobial agents are the main ones in the treatment regimen for chlamydia. Typically, for chronic chlamydia, drug treatment consists of using a combination of two antibiotics. The individual dosage and duration of treatment are determined by a specialist, taking into account the type of disease, as well as the inflammatory process.
When selecting antibiotics for the treatment of chlamydia, laboratory data to determine the sensitivity of the pathogen to a particular antibacterial drug are indispensable. For this reason, it is advisable to supplement cultural diagnostic methods with an antibiogram.
Antibiotics |
|
Drug name |
Treatment regimen |
"Erythrocin" ("Erythromycin") |
4 times a day 500 mg 1 hour before meals, duration of treatment is 10-14 days or more than 14 days (for complicated and chronic). |
"Doskycycline" ("Vibra-Tabs", "Vibramycin", "Dorix") |
2 times after meals, 100 mg, duration of treatment is the same as for Erythromycin. |
"Zithromax", "Sumamed" |
250 mg once a day, course duration - 11 days, full course 3 years, with the first dose - 500 mg, in case of complications - 2 weeks. |
"Levaquin" ("Lomefloxacin") |
600 mg once a day after meals for 10-14 days, in case of complications - more than 14 days. |
“Ofloxacin” (“Ofloxin”, “Tarivid”, “Zanocin”, “Floxin”) |
2 times a day, 300 mg after meals. 10 days for the usual form and 14 days for the complicated form. |
"Vilprofen" |
2 times a day, 500 mg, 10-12 days after meals, in complicated forms for 14 days. |
"Rovamycin" |
3 times a day, 3 ml. IU two hours after eating for 10 days (14 days in the complicated form). |
"Abaktal" ("Pefloxacin") |
2 times a day, 400 mg with meals for 10 days (14 days for a complicated form). |
"Levofloxacin" ("Norbactin", "Nolicin", "Urobacid") |
2 times a day, 500 mg, for 7 days. |
"Ciprofloxacin" ("Ciprobay", "Cifran", "Cipro-bid", "Ciprinol"). |
2 times a day, 400 mg, for 7-10 days. |
Treatment regimen for chlamydia
During treatment of the lower part of the urogenital tract, namely in uncomplicated forms, you need to resort to the following treatment regimen:
Preparation – a week. It begins with immunocorrection if a violation of the immune status is detected - “Polyoxidonium” or “Amiksin”. Systemic enzyme therapy – “Wobenzym” or “Trypsin2. Local treatment - microenemas with chlorhexidine solution, baths, instillation. Vitamin therapy – vitamin E, any multivitamin complexes.
Basic treatment – treatment duration is 2 weeks. Antibiotics for 2 weeks, enzymes to improve digestion, antifungal agents according to indications - “Mezim”, “Festal”, “Pancreatin”, basic treatment is carried out while the first stage of treatment is ongoing.
Recovery – 2 weeks. Restoration of intestinal microflora by taking hepatoprotectors, probiotics, physiotherapy as indicated.
How is chronic chlamydia treated?
The treatment regimen for chronic chlamydia directly depends on the degree of clinical symptoms and the combination of different bacterial infections. For complicated forms (inflammation of the pelvic organs in women, scrotum and men) of atypical inflammation, the following treatment regimen is recommended:
Basic treatment. Immune drugs, antibiotics, antioxidants, vitamin therapy. 7 days after starting antibiotics, systemic enzyme therapy and antifungal (antimycotic drugs) are added.
Recovery stage. Hepatoprotectors, physical therapy is possible - ultrasound, laser-magnetic effects. Treatment should be supplemented with local procedures - microenemas, baths with a solution of chlorhexidine and perftoran.
Treatment for indolent chlamydia:
Preparation. Systemic enzyme therapy, immunotherapy for 2 weeks, local treatment.
Basic treatment. A week after the start of the first stage of treatment, antifungal agents, antibiotics, antioxidants, and multivitamins are prescribed.
Recovery. Hepatoprotectors, physiotherapy, hyaluronidase preparations - probiotics, Longidase, antioxidants, local treatment.
Treatment with drugs for chlamydia will be effective if:
For treatment, only drugs are used that are characterized by high anti-chlamydial activity and easily penetrate into the cells.
The timing of infection will be taken into account - fresh infection, chronic course, clinical picture of inflammation - acute, asymptomatic, subacute, torpid.
Finally, it is worth recalling that the course of therapy should only be prescribed by the attending physician; self-medication and self-diagnosis are not acceptable, as they can negatively affect your health.
Chlamydia is a common infection, transmitted mainly through sexual contact. The main danger lies in the complication of this disease - possible infertility. Therefore, successful treatment of chlamydia in men begins with early diagnosis of the disease and properly selected therapy using medications from various groups. Preventative measures will help prevent the spread of the disease.
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The surface of the pathogen contains a large number of antigenic structures, thanks to which the immune system recognizes the foreign unit and comes into contact with it.
Kinds
Based on the set of antigens, a large group of chlamydia is divided into types:
The diseases they cause have a variety of clinical manifestations.
Outside the human or animal body at room temperature, chlamydia can live for about 24 hours, then dies. But C.psittaci stays in the external environment for about 2 weeks. High temperatures, ultraviolet radiation, antiseptics and disinfectants have a detrimental effect on bacteria. At the same time, low temperatures do not pose a threat to them.
A special feature of chlamydia is that it is capable of forming special “dormant” forms in order to survive unfavorable environmental conditions: the pathogen can quietly reside in the host’s body, but not manifest itself, since the immune system does not come into contact with the bacterium. Trachomatis “wakes up” only at the moment of immunosuppression, i.e., a decrease in the local defenses of the body.
Routes of infection
Infection most often occurs through sexual contact, but transmission of the disease to the fetus from the mother through the placenta is possible. We should not exclude the contact and household route of infection: through shared dishes, towels, in a sauna or bathhouse. The incubation period lasts from 2 weeks to 1 month.
Pathogenesis
Chlamydia trachomatis has a number of features:
Clinical picture of chlamydia
In men, chlamydia most often occurs as urethritis - lesions of the lower parts of the urogenital tract. Such urethritis has poor clinical symptoms: scanty transparent discharge is sometimes the only manifestation of pathology. But this is not a pathognomonic sign, since they can be detected in many diseases.
Clinical picture of chlamydia:
- Dysuria (impaired urination), itching and burning in the urethral area. When examining the head, you can detect swelling and hyperemia in the area of the external opening of the urethra.
- Symptom of intoxication- an increase in temperature to low-grade levels (37.3 C), headaches, body aches and general malaise. Streaks may appear in the urine, sometimes bloody. The color of urine sometimes changes from light to cloudy.
- Asymptomatic course of the disease- this condition should be distinguished from carriage. In the first case, the patient is still sick: there is suppression of local immunity and active reproduction of the pathogen, and with carriage the person is clinically healthy, but when using high-precision research methods, chlamydia is detected. This condition is associated with the work of the immune system, which suppressed the proliferation of chlamydia.
Classification of chlamydial infections
According to ICD-10 (international classification of diseases, tenth revision), chlamydial infections of urogenital localization are divided into several types:
But for clinical practice and prescribing adequate therapy, doctors use a simpler classification:
- 1. Chlamydial infection of the lower sections.
- 2. Upper sections.
- 3. Persistent/recurrent.
There are chronic and fresh forms of chlamydia.
Treatment
With the right treatment, chlamydia can be eliminated forever. The main goal of therapy is to destroy the main pathogen (C. trachomatis) and reduce the clinical manifestations of the disease. The main cure for this disease is antibiotics, prescribed in the form of tablets or injections.
Detection of chlamydia in a man requires parallel examination and, if necessary, treatment of the sexual partner.
General principles of treatment of the disease:
Drug of choice Photo Doxycycline Josamycin Azithromycin Mild forms of pathology require treatment for approximately 7-14 days. Complicated - longer use of a course of antibiotics, from 21 to 28 days.
Sometimes, in the treatment of complications such as chronic prostatitis, the use of alpha-1-blockers, NSAIDs and levofloxacin is indicated.
Modern tactics
Therapy of the lower urogenital tract
Diseases of the lower sections are uncomplicated, therefore, in addition to antibacterial therapy, additional treatment is not required.
Preparations:
Group Drug of choice Other drugs Side effects Tetracyclines Doxycycline, course up to 7 days: its advantage is high efficiency and low cost, the drug has higher bioavailability and half-life, and is also better tolerated by the patient. You do not need to follow a special diet when taking Doxycycline Metacycline: diet must be followed (binds with Ca ions All tetracycline drugs are contraindicated in renal failure and pregnancy, and are not recommended for the treatment of children under 8 years of age. Side effects include diarrhea, vomiting, and nausea. During treatment with tetracyclines, you should avoid sunbathing, as the drugs can lead to photosensitivity. Macrolides Azithromycin: concentration in tissues at a fairly high level is observed after the first use of the antibiotic and remains at the site of inflammation for at least 7 days Spiramycin, Roxithromycin, Erythromycin, Josamycin, Clarithromycin and Midecamycin Vomiting, nausea and diarrhea, and from the liver - increased transaminases, yellowness of the sclera. Sometimes allergic reactions are possible. Fluoroquinolones Ofloxacin: the antibiotic has almost 100% bioavailability Pefloxacin or Lomefloxacin Side effects are the same as the previous two groups Despite the high activity of fluoroquinolones, after taking them there is a high risk of relapse of chlamydia. Therefore, this group is used for mixed gonorrheal-chlamydial form.
Nevertheless, fluoroquinolones are the most actively developing group of antibiotics, which includes the most modern drugs. New generations of antibiotics are superior to their predecessors. The third generation drug - Levofloxacin - is used not only in the treatment of chlamydial diseases, and the fourth generation - Moxifloxacin - opens up new opportunities in the treatment of many bacterial infections.
Therapy of persistent and recurrent forms
A persistent infection is associated with a special cycle of the pathogen: the bacterium can stop it, then antibiotics will only act on “adult” bacteria, and those that stop in their development will be left untouched. But it is also necessary to treat this type of disease, because the presence of “immature” forms leads to serious immune disorders or even infertility.
Recently, a scheme was proposed according to which the persistent form is treated with the help of immunocorrectors, and then a course of antibiotics is prescribed. This is explained by the fact that numerous studies have proven that the formation of persistent forms is associated with T-lymphocytes and some types of B-lymphocytes.
Immunocorrectors are prescribed:
- 1. Polyoxidonium in the form of injections: after the fourth, antibiotic therapy can be prescribed.
- 2. A-interferon suppositories, the dosage is determined by the doctor.
After immunocorrection, a course of antibiotics is prescribed according to the treatment regimen for complicated chlamydia.
After completion of therapy, its effectiveness is determined according to the scheme.
Treatment regimens for chlamydia are quite complex and are selected taking into account the characteristics of the course of the disease and associated complications. Therefore, under no circumstances should chlamydia be treated at home or with folk remedies.
Complications of male chlamydia
If treatment is untimely or incorrect, complications may develop such as:
- Narrowing (stricture) of the urethra with the formation of scar tissue (requires surgical treatment).
- Orchiepididymitis, leading to the death of cells responsible for spermatogenesis (leads to persistent infertility).
- Chronic prostatitis.
- Reiter's disease.
20.06.2017
Chlamydia is a ubiquitous and extremely common disease transmitted through sexual contact.
The household route of infection (through hands, towels, and underwear contaminated with infected secretions) is also possible, but is not a significant epidemiological factor. Newborns are often infected when passing through the birth canal of a sick mother (in 50% of cases); there may be intrauterine infection. In fact, it is a sexually transmitted disease, although it is more often treated by urologists and gynecologists.
According to statistics, from 30% to 60% of adult women and about half of men are infected with chlamydia (chlamydia trachomatis). In more than half of cases, the disease is asymptomatic.
Symptoms and treatment vary at different stages of the disease. There are two forms of chlamydia:
- “fresh” form, which lasts up to 2 months from the moment of infection and affects the lower part of the genitourinary system;
- chronic form, when the infection spreads to the upper parts of the genitourinary system and more than 2 months pass from the moment of infection.
In the “fresh” form, approximately 2 weeks after infection, a burning sensation when urinating, an increase in the amount of vaginal discharge, which acquires an unpleasant odor, may appear. Soon the symptoms go away on their own, and the woman in most cases forgets about this episode. Meanwhile, she should see a doctor: the “fresh” form is easy to diagnose and quite easy to treat.
With the development of chronic chlamydia, symptoms of diseases of the female genital area may occur. Chlamydia in women can cause inflammation of various locations:
- Bladder;
- labia minora and labia majora;
- mucous membrane of the cervix;
- Bartholin's glands;
- vaginal mucosa;
- fallopian tubes;
- endometrium of the uterus.
Chronic chlamydia can cause infertility (due to adhesions in the fallopian tubes) and pregnancy pathologies (frozen pregnancy, spontaneous abortion, premature birth, developmental disorders in the fetus when it is infected). Babies may develop chlamydia-related pneumonia and conjunctivitis soon after birth.
Manifestations of chlamydia not related to the genital area may include chronic “colds” of the upper respiratory tract, inflammation of the rectum - proctitis, conjunctivitis, reactive arthritis.
The microorganism chlamydia trachomatis is a bacteria, but its behavior resembles a virus. Chlamydia, like viruses, is embedded in the cells of the host’s body and can leave them during reproduction without destroying the cell, which explains the usually erased or asymptomatic course of the disease. With high immunity in humans, chlamydia forms inactive (latent, persistent) L - forms that do not extend beyond the host cell. In this case, chlamydia reproduces only during cell division. The immune system does not produce antibodies to them, which complicates diagnosis by enzyme immunoassay. The same feature makes it difficult to treat chronic chlamydia: chlamydia is sensitive to antibiotics, but not in all phases of its life cycle. Chlamydia began to be recognized as an independent diagnosis in 1977. Previously, numerous chlamydial inflammatory diseases of the urogenital area were classified as female diseases of unknown etiology.
The most reliable diagnostic methods today are PCR (polymerase chain reaction) - testing scrapings of the epithelium of the urogenital tract (the reliability is close to 100%) and the enzyme immunoassay of venous blood for the presence of antibodies (the reliability is about 60%). Typically, diagnosis is prescribed for existing inflammatory processes in the urogenital area, as well as before childbirth or abortion, in case of miscarriage or intrauterine fetal death. It is strongly recommended that when planning a pregnancy (on your own initiative and by both future parents), you should be tested for hidden sexually transmitted infections, including chlamydia, and if the result is positive, treat chlamydia before pregnancy. So, how to treat chlamydia in women?
The main goal of treatment is to destroy chlamydia and get rid of acute or chronic inflammatory processes. An intermediate goal may be to reduce the number of relapses of chronic inflammatory processes and reduce the likelihood of a complicated or miscarried pregnancy.
There are no universal drugs for chlamydia in women. The main treatment is antibiotics. When developing a treatment regimen, the form of the disease (acute or chronic) and the presence of concomitant infections are taken into account. The duration of the course of antibiotics is at least 6 life cycles of chlamydia, which last from two to three days, therefore, at least 12, and more often 18 days.
Antibiotic therapy for chlamydia is selected based on the requirements:
- the antibiotic must be highly active against chlamydia;
- the drug should easily penetrate into the intracellular space and create the required concentration;
- the drug must have low toxicity and be affordable for the patient.
The duration of treatment should cover 4, preferably 6 life cycles (48-72 hours) of chlamydia. Treatment will be effective if chlamydia is in a form sensitive to antibiotics (reticular cells, non-dividing forms - elementary bodies and inactive L - forms resistant to antibiotics). The choice of medication should take into account the time from the moment of infection (up to 2 months “fresh”, more than 2 months chronic), the presence of symptoms of inflammation, the presence of additional infections, whether antibiotics were used during chlamydial infection, the nature of immune changes, especially in the presence of inactive (persistent) L - forms , which is determined by the results of an immunogram. Various groups of antibiotics are used in medical practice (see Table 1). Of the sulfonamides (in case of intolerance to antibiotics), only biseptol is used.
Drugs for the treatment of chlamydia
Antibiotics used for chlamydia
Group | Name | Efficiency | During pregnancy |
Macrolides | Erythromycin, erythromycin - base (erigexal, eric, eracin) josamycin (vilprafen), spiramycin (rovamycin), roxithromycin | High ability to penetrate cells. High efficiency | Josamycin can be used, others are acceptable with caution |
Macrolides azalides | Azithromycin (sumamed) | High penetration ability. High efficiency, including for mixed infections | Carefully |
Tetracyclines | doxycycline (vibramycin), metacycline (rondomycin) | Average penetration ability. Effective in “fresh” form | Only intravaginally in the 2nd and 3rd trimesters |
Fluoroquinolones | ofloxacin, lomefloxacin, pefloxacin | Average ability penetration. Alternative drugs |
Contraindicated |
Lincosamides | clindamycin | Effective for chronic and mixed forms | Safety of use has not been established |
Basic antibiotic treatment regimens:
- continuous course of treatment (at least 7 life cycles of chlamydia);
- pulse therapy (3 courses of antibiotics for 7 days with pauses of 7 days) for the chronic form.
Antibiotic treatment options:
- monotherapy with one drug (in 25-50% it does not completely destroy chlamydia);
- combination therapy (usually 2 antibiotics from different groups).
In most cases, and especially in the presence of mixed infection, combination therapy is used.
The effectiveness of treatment is increased by immunomodulation, which can be carried out both before the start of antibiotic therapy and in parallel with it. The regimen for using immunomodulators and the choice of drugs should be based on the results of an individual immunogram.
Immunomodulators
Interferogens (interferon inducers) and interferons are used. New interferogens cycloferon and its analog neovir stimulate the production of their interferon in the body. Of the foreign interferons, it is advisable to use viferon, which has the most gentle effect on the immune system. Viferon is available in the form of rectal suppositories and contains interferon α – 2b, vitamin E and ascorbic acid. Viferon can be used by pregnant women, debilitated patients, and for the treatment of newborns and premature babies.
In the situation of a persistent form of chronic chlamydia (inactive L forms), antibiotic therapy does not make sense. In this case, immunotherapy will be the main treatment method. The body itself will fight chlamydia.
Probiotics
All developed treatment regimens using antibiotics are quite aggressive and cause intestinal dysbiosis and also change the vaginal flora.
Intestinal dysbiosis is treated with the drugs Bifidum, Bificol, Lactobacterin, Hilak-Forte and other probiotics.
To restore vaginal flora, acylact (vaginal suppositories), bifidumbacterin (suppositories), and gynoflor vaginal tablets are used.
Hepatoprotectors
To maintain liver function, Carsil, Essentiale Forte, Phosphogliv, Legalon and others are prescribed.
Antifungal drugs
To prevent candidiasis while using antibiotics, nystatin, nizoral, levorin, and fluconazole are prescribed.
Local remedies
Can be applied locally:
- douching with weakly acidic (2%) solutions of boric, lactic or citric acid;
- vaginal tampons, which may contain macrolide antibiotics, tinidazole, nystatin, ascorbic acid, dimexide, sea buckthorn oil, olive oil and other ingredients.
On medical portals, users ask a lot of questions about the problem of chlamydia, usually starting with the words “looking for” and “being treated.” Patients who are looking for a “cure for chlamydia” or “drugs for the treatment of chlamydia in women” on the Internet should know: an effective treatment regimen for chlamydia is developed only individually, by a qualified doctor after appropriate research and medical history.
Treatment should be accompanied by a number of tests and completed with control studies, with subsequent monitoring 4 to 6 weeks after the end of treatment.
Prevention
Disordered sex life with multiple partners should be avoided. Chlamydia can easily be contracted through genital or anal intercourse without a condom. Infection through the oral route is possible, but less likely. Chlamydia does not develop immunity, and you can become infected again and again. Therefore, regular partners are treated at the same time.
It is important for women and girls to exclude household infection by observing sanitation rules and reasonable caution when visiting public places.
Although infection in this way is unlikely, you should not sit on a bench in a bathhouse without a bedding, touch your genitals with the hand that was used to cover the hook in a public toilet, and the like.
Sexually active men are infected with chlamydia in 5-15% of cases. Moreover, this disease is diagnosed three times more often than gonorrhea.
The infection spreads quickly, as it rarely manifests itself at the initial stage. But subsequently, its untimely diagnosis and lack of treatment can lead to a number of complications, the most dangerous of which is infertility.
Therefore, it is important to know what chlamydia is in men, treatment, and drugs used to destroy them.
This is one of the most common sexually transmitted diseases, the appearance of which is promoted by Chlamydia.
This is a special microorganism that is an intermediate link between bacteria (similar structure) and viruses (lives inside cells).
Therefore, it is difficult to identify and remove from a living organism.
It enters the human body after unprotected sexual contact, through infected underwear, hands, and from an infected mother to her child.
About 50% of men are carriers of chlamydial infection.
Chlamydia does not manifest itself for a long time. But sometimes a small amount of white mucus is released from the urethra. Also, the genitals may become red and itchy, and sometimes discomfort is felt during sexual intercourse.
After years of asymptomatic progression, if medications for men against chlamydia have not been used, a number of complications may develop:
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To prevent such consequences from developing, it is important to know how to treat chlamydia in men.
Drugs to treat the disease can be different, but antibiotics and modern drugs that penetrate the cell membrane are most often used.
Treatment methods for chlamydia
How to treat chlamydia in men? The drugs prescribed for chlamydial infection are antibiotics and immunoglobulins. Etiotropic treatment is often carried out, which involves taking various groups. Another scheme may also be used.
Treatment of chlamydia in men: medications and their dosage regimen should be prescribed only by a doctor.
Attention: To prevent complications from developing due to chlamydia, healthy people are given a special vaccine.
The second method of treatment for chlamydial infection ( eubiotic) consists of taking antibiotics and drugs that prevent the development of dysbiosis.
After all, drugs against bacteria destroy not only pathogenic, but also beneficial microflora.
Therefore, additional drugs for the treatment of chlamydia in men are products containing lactobacilli.
But at the same time, the patient should adhere to a special diet, which included the consumption of fermented milk products.
Also prescribed for chlamydia enzymes. These products activate metabolism, improve digestive function, stimulate the immune system and thin the blood. To maintain the functioning of the body at the desired level and remove toxins from it, they are prescribed immunostimulants.
All of the above drugs for the treatment of chlamydia for men can be used simultaneously.
However, the course of therapy and dosage are determined by a venereologist, gynecologist or urologist. After all, men over 40 years of age, in addition to chlamydia, may have other chronic diseases that require separate treatment.
Reference: The average duration of therapy for chlamydial infection is 25 days.
Drugs
If there is chlamydia in men, the drugs that are most effective in treating are:
- macrolides;
- tetracyclines;
- fluoroquinolones.
Macrolides
If there is chlamydia in men, the symptoms determine treatment with drugs that are selected by the doctor depending on various factors (the nature of the disease, the extent of the lesion, age, the presence of concomitant diseases).
For acute and chronic forms of infection, macrolides are prescribed. This group of antibiotics includes many drugs, which include:
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To increase the effectiveness of treatment, it is necessary to simultaneously take antibiotics from different groups.
Tetracyclines
The second most popular group of antibiotics used for chlamydial infections are tetracyclines.
Tetracycline dosage is 500 mg 4 times. per day. The course of therapy is up to 14 days. Doxycycline is prescribed in a lower dosage - 100 mg 2 times. per day for 1-2 weeks.
Fluoroquinolones
Fluoroquinolones are least often prescribed for chlamydial infection.
They are used if the first two groups of antibiotics are ineffective.
If chlamydia is detected, the doctor prescribes Ofloxacin.
It is taken once (400 mg) or twice 200 mg) per day. Duration of treatment – 9 days. Ciprofloxacin is sometimes prescribed, but in most cases chlamydia is resistant to this antibiotic.
Reference: in 70% of cases, immunotherapy helps cure chronic chlamydia.
Treatment regimens for chlamydia
Chlamydia, treatment in men. The medications and course of treatment are selected individually. But there are certain therapeutic regimens that are most effective.
Scheme No. 1:
- Antibiotics – Unidox, Azithromycin;
- Immunostimulants – Lidaz with novocoin;
- Hepatoprotectors – Essliver forte;
- Antiseptics for topical use – Miramistin, Chlorhexidine.
- The duration of therapy is at least three weeks.
Scheme No. 2
The use of antibiotics Ofloxacin and Dloxycycline in combination with Enzyme Complex Plus. Duration of therapy is up to 15 days.
Additional drugs and procedures
To completely cure chlamydia and prevent its re-development, you need to drink vitamins.
To restore the body, synergists, antioxidants and vitamin complexes are prescribed:
- Vitamin E – 1 pill twice a day for two weeks.
- Glutamic acid – 2 tablets three times a day for 14 days.
- Na thiosulfate – 10 injections daily at a dose of 10 ml IV.
- Ascorbic acid – three tablets three times a day for two weeks.
To restore microflora it is necessary to take probiotics.
There are no contraindications to taking these drugs, the only thing is that some patients may develop allergies.
These drugs include Lactobacterin, Enterol, Bifidobacterin, Bifikol. The drug is taken three times a day. Duration of treatment is 2-3 weeks.
Important: to speed up the treatment process for chlamydia, it is useful for men to do prostate massage, baths, enemas, urethral instillation and physiotherapeutic procedures.
It is very important not to be sexually active during treatment.
Moreover, if a man has a regular partner, then he should also undergo a course of therapy. When you finish taking the medications, you need to be tested again, which will make sure that there are no more chlamydia in the body.
In contact with
Chlamydia is a group of infectious diseases caused by chlamydia. This is a type of microorganism that is neither bacteria nor viruses; chlamydia is a prositary agent that multiplies intracellularly, so diagnosing the cure and treating chlamydia in men is significantly difficult. The insidiousness of this pathogen is that in almost half of the cases, chlamydia in men does not show symptoms.
In constant stressful situations, poor nutrition, lack of proper rest, when a person has disorders in the immune system, the adequate immune response to infection weakens - chlamydia can affect the cardiovascular system, the respiratory system - chlamydial pneumonia, the musculoskeletal system - chlamydial arthritis, organs vision - conjunctivitis, but the most common localization of these infectious agents is the male genitourinary system.
Urogenital chlamydia is manifested by symptoms of cystitis, prostatitis and urethritis. This disease can only be determined using specific tests, enzyme immunoassay (ELISA), serological and molecular biological methods. Chlamydial infections pose a health hazard because they have multiple complications - impaired potency from ascending genital tract infections, joint damage, male infertility, vascular and heart diseases.
Therefore, if the slightest suspicion arises due to a disorder in the genitourinary area, the diagnosis of chlamydia should be excluded or confirmed. In men, venereologists, infectious disease specialists, and urologists treat this disease.
Routes of transmission of chlamydia in men
Chlamydial infection occupies a leading place among all sexually transmitted diseases. Every year in our country, 1.5 million people become ill with urogenital chlamydia; chlamydia is most often registered at the age of sexual activity of 20–40 years; today there is an increase in the incidence among 13–17 year old adolescents. The source of infection can be persons with both asymptomatic and active disease.
Routes of transmission of chlamydia in men and women.
- Contact. The most common is the sexual transmission of chlamydia, regardless of the method of contact. It is possible, but unlikely, through household or family contact, through shared personal hygiene items, clothing, bedding, and dirty hands.
- Vertical: Antenatal - during a woman’s pregnancy and intranatal - during the birth of a child, it is transmitted from mother to baby.
Signs of chlamydia in men
In 46% of men, the disease is asymptomatic, but even in this case the person is a carrier of the infection and is potentially dangerous to the sexual partner. The incubation period of chlamydia is 14-28 days, and often the first symptoms of the disease are observed two weeks after questionable contact. How does chlamydia manifest? Symptoms and signs of the disease may include the following:
- In acute chlamydia in men, the symptom is low-grade body temperature 37.2-37.5C, general weakness, and increased fatigue.
- The urethra may be glassy, watery or watery, especially noticeable after sleep.
- When urinating, itching and burning may occur, and the first drops of urine may be cloudy.
- An acute inflammatory process in men may be accompanied by bloody discharge during ejaculation, or at the end of urination.
- The external opening of the urethra may be swollen and red.
- Sometimes men feel unpleasant or painful sensations in the groin and lower back.
- After infection, the symptoms of chlamydia often subside, discharge may occur only occasionally in the morning, and the person forgets about it and does not see a doctor. Therefore, the acute phase of the disease often turns into chronic, leading to prostatitis, cystitis and other diseases.
Urogenital chlamydia in men - treatment
How to treat chlamydia? In men, the problem of treating this disease is that the patient seeks the services of specialists late and often doctors have to deal with advanced chronic urogenital chlamydia.
When treating chlamydia, the drugs of choice are based on the characteristics of chlamydia, namely that the vital activity of these microorganisms occurs inside cells. Therefore, only tetracycline antibiotics, macrolides and fluoroquinolones are the most suitable for therapy. The use of cephalosporins, sulfonamides and penicillins is not advisable due to their low natural activity against chlamydia.
Before treatment, the attending physician determines the duration of infection, the onset of the first symptoms, intolerance to any drugs, possible allergic reactions and other chronic diseases. Also, based on laboratory tests, the following is clarified:
- Immunity status
- Condition of the hepatobiliary system - liver, gallbladder, pancreas
- Intestinal microbiocenosis
- Condition of the urogenital tract
When treating chlamydia in men, medications are selected by a specialist also taking into account concomitant STDs - sexually transmitted diseases, since chlamydia is often accompanied by other infections:
- Antibiotics. The following drugs are prescribed:
- Tetracyclines: Doxycycline - Unidox Solutab, Dorix, Vibramycin, Vibra-Tabs.
- Macrolides: Azithromycin (Sumamed, Zithromax, Hemomycin), Josamycin (Vilprafen) and Clarithromycin (Clarbact, Fromilid Uno)
- Fluoroquinolones: Ofloxacin (Floxin, Zanotsin, Tarivid, Ofloxin), Levofloxacin (Tavanic, Glevo, Levostar, Flexid), Ciprofloxacin (Cifran, Tsiprobay, Tsiprinol, Cipro-bid), Spiramycin (Rovamycin), Norfloxacin (, norbactin), Lomefloxacin ( Lomflox), Sparfloxacin (Sparflo).
- Sometimes in treatment regimens for chlamydia in men with a complicated process, 2 antibiotics are used at once, as well as antifungal agents (Pimafucin, Fluconazole):
- azithromycin with ciprofloxacin
- rifampicin with ciprofloxacin
- doxycycline with ciprofloxacin .
There is no one-size-fits-all treatment for men, since in each specific clinical case a qualified doctor determines an individual complex treatment regimen, taking into account all concomitant diseases, the patient’s age, his individual sensitivity and other factors.
Chlamydia in men - consequences of infection
In advanced forms of chronic chlamydia in a man whose treatment has not been carried out or has proven to be ineffective, the patient is at risk of developing serious diseases such as prostatitis, epididymitis, and urethritis.
- Symptoms of prostatitis- when the prostate gland is inflamed, men experience pain in the rectum, lower back, groin, difficulty starting urination, discharge from the urethra is mucous or watery, and potency is impaired.
- Symptoms of urethritis- itching in the urethra, frequent urge to urinate, purulent or mucopurulent discharge; with chronic chlamydial urethritis, urethral stricture may develop.
- Symptoms of epididymitis is an inflammation of the epididymis, which is usually characterized by high body temperature, enlargement of the epididymis, which ultimately leads to infertility and impaired spermatogenesis.
- Reiter's disease- chlamydial conjunctivitis, arthritis.